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Sepsis, Emergency Medicine

Reviewed 06/2017



  • Presence of an infection with an associated systemic inflammatory response

  • The systemic inflammatory response syndrome (SIRS) is composed of 4 criteria:

    • Temperature >38°C or <36...


Signs and Symptoms


  • Question for signs of infection and a systemic inflammatory response:

    • Fever

    • Dyspnea

    • Altered mental status:

      • Change in mental status

      • Confusion

      • Delirium

    • Nausea and vomiting

  • Loo...



Aggressive fluid resuscitation for hypotension 

Initial Stabilization/Therapy

  • ABCs

  • Supplemental oxygen to maintain PaO2 >60 mm Hg

  • Intubation and mechanical ventilation if shock or...



Admission Criteria

Sepsis almost always requires inpatient care. 

Discharge Criteria

Patients with less severe infections (e.g., streptococcal pharyngitis) meeting the criteria for s...

Pearls and Pitfalls

  • Start antibiotics as soon as sepsis is suspected.

  • Failure to recognize multiorgan failure and initiate aggressive fluid resuscitation in the initial presentation of sepsis is a pitf...

Additional Reading

  • Barochia  AV, Cui  X, Vitberg  D, et al. Bundled care for septic shock: An analysis of clinical trials. Crit Care Med.  2010;38:668–678.

  • Martin  JB, Wheeler  AP. Approach to the...



  • 038.42 Septicemia due to escherichia coli [E. coli]

  • 038.43 Septicemia due to pseudomonas

  • 995.91 Sepsis

  • 079.99 Unspecified viral infection

  • 038.10 Staphylococcal septicemia, unspecified

  • 038.40 Sept...

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